CPT code 24331 is for a surgical procedure involving flexor-plasty of the elbow with advancement.
CPT code 24331 is for a surgical procedure known as a flexor-plasty of the elbow with advancement. This procedure involves reconstructing the flexor muscles of the elbow, often to restore function or improve movement. The "advancement" part of the description indicates that the surgeon repositions the muscle or tendon to a new location to enhance its effectiveness or to correct a deformity. This type of surgery is typically performed to address issues such as muscle weakness, injury, or conditions that limit the elbow's range of motion.
For CPT code 24331 (Flexor-plasty elbow with advancement), the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both elbows during the same operative session.
3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 53 - Discontinued Procedure: Used when a procedure is discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
6. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
7. Modifier 76 - Repeat Procedure by Same Physician: Used when the same procedure is repeated by the same physician.
8. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is repeated by another physician.
9. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Used when a related procedure is performed during the postoperative period of the initial procedure.
10. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period of the initial procedure.
11. Modifier 80 - Assistant Surgeon: Used when an assistant surgeon is required during the procedure.
12. Modifier 81 - Minimum Assistant Surgeon: Used when a minimum assistant surgeon is required during the procedure.
13. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is required and a qualified resident surgeon is not available.
14. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Used when these non-physician practitioners assist in the surgery.
Each of these modifiers serves a specific purpose and should be used accurately to ensure proper billing and reimbursement. Always refer to the latest CPT and payer guidelines for the most current information.
The CPT code 24331 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). To determine the exact reimbursement rate and any applicable guidelines, healthcare providers should consult the MPFS, which provides detailed information on the payment policies and rates for services covered by Medicare. Additionally, it is essential to verify with the local Medicare Administrative Contractor (MAC) for any region-specific rules or additional documentation requirements that may affect reimbursement for CPT code 24331. The MAC is responsible for processing Medicare claims and can provide the most accurate and up-to-date information regarding coverage and payment for this specific code.
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